How Mayo Clinic Standardized Care Across 22 Emergency Departments
Christopher S. Russi, DO, FACEP (Chair - Division of Community Emergency Medicine
Organizations pursuing an M&A strategy while trying to achieve clinical standardization face a unique set of challenges. The piecemeal addition of facilities often results in sites with dissimilar cultures and conflicting approaches to clinical operations. This is problematic for two reasons. First, unless they create very clear, succinct operational efficiency to deliver high quality, they risk losing money. Second, variation between sites poses opportunity costs in terms of quality, when best practice clinical standards are not being consistently applied.
In 2012, Mayo Clinic Health System recognized the financial and quality opportunities of standardizing the clinical operations of their emergency departments. So, they tasked a physician-administrator dyad with an ambitious goal: harmonize the clinical operations of all 22 of Mayo’s emergency departments in Minnesota. The facilities ranged from Mayo’s flagship academic medical center ED to several small critical-access sites; in aggregate, the facilities saw over 350,000 patients annually.
While all Mayo facilities, the sites had different cultures, bylaws, physician compensation, and leadership structures. Adding to their challenge, many sites were paying below market-level salaries, and several were relying heavily on temporary physicians. With these challenges in mind, Dr. Christopher Russi, the chair of community emergency medicine, and Aaron Keenan, an operations administrator, were given the assignment to move forward and make this happen.
In this session, learn from Dr. Russi how they accomplished their tasks by
- Reorganizing the 22 academic and community EDs under a singular leadership structure
- Standardizing physician salaries across the EDs and creating a centralized recruitment process
- Creating new, more appealing rotational roles for both physicians and physician leaders
- Standardizing nursing education and protocols across facilities
- Learning the importance of in-person visits critical to getting buy-in and driving change
Within one year the results included: reduced transfer rates, dropped service line write-offs, improved billing and coding, rising HCAHPS scores, and increased success with hiring and retention saving significant contract hiring costs.